This invention relates to a system and method for managing insurance claims work flow. More particularly, this invention relates to a method and system of handling insurance claims from an initial claim through final settlement.
Insurance companies generally process a claim by performing a number of related tasks that include numerical cost estimates, information management, and communications between, for example, insurance company offices and employees in the field. The sum of tasks performed in claims processing define a workflow that must be accommodated in the insurance industry. Existing methods and systems for handling insurance claims are typically limited to undertaking only one or a few of the daily tasks that make up insurance claim workflow. For example, some methods are limited to calculation of a specific type of damage or injury and generating an estimate for repairing or replacing the damaged or injured item.
The calculation of a repair cost estimate is often done on a computer by entering reference data from external sources. The computer program may generate a numerical value as a result of looking at the data from the external sources and comparing it to the items that need to be replaced or repaired. In one estimating system, a vehicle claim estimate related to car panel and chassis damage is calculated and provided to a user. In another system, an auto bodyshop generates an estimate, including a digitized image of the vehicle, that may be transmitted via modem to an insurance company. Other tasks necessary to insurance claims processing, such as communication between an insurance company and repair facilities or managing of correspondence are typically handled separately.
The various available methods and systems for generating insurance costs and estimates are typically further limited to individual discrete calculations. After an appraiser prepares an estimate for repairing a vehicle, a separate calculation is often completed through a separate computer program to compute total loss valuation of a vehicle. Although these individual calculations may be obtained through separate programs, the results of each of the programs are difficult or awkward to compare because of the separate programs and datafiles involved.
Similarly, although separate methods and systems for performing some of the administrative tasks in insurance claim processing workflow are available, each of these separate computer programs requires certain types of data and each outputs a certain type of data. The data required for the separate programs may overlap and lead to redundant data entry tasks being performed. Data sharing between the different, discrete methods and systems that an insurance company uses may be difficult due to incompatible data formats. Therefore, an insurance claim adjuster must spend time keeping track of, and running, the separate programs. Appraisers, repair shops, and others involved in claim processing often need to switch between, and learn how to operate, separate software programs having separate data and interface requirements. Present methods of handling insurance claims not only tend to require the use of separate software and hardware tools for various calculations, but also require separate organization of administrative material and client mailings to the insured party. Insurance companies often juggle many separate computer files and pieces of paper generated for each claim.
Accordingly, there is a need for a comprehensive system and method of managing an insurance claim work flow wherein all the tasks of processing a claim may be performed and evaluated. Such a system would have a common user interface to access the various calculation tools and administrative steps. It would also be advantageous to have a centralized electronic datafile containing all data relevant to a claim that would eliminate the need for separate paper files or datafiles and eliminate the need for wasteful reentry of existing data.